Exploring the Association Between Patient-Centered Communication and Awareness of Human Papillomavirus Vaccine: A Cross-sectional Study

Purpose: Human papillomavirus (HPV) vaccination is effective in preventing anogenital and oropharyngeal cancers, including genital warts. The HPV vaccine is approved for individuals aged 9-45 years old and creates the opportunity for healthcare providers to educate parents, caregivers, and patients on the benefits of the vaccine. Effective provider-patient interactions promote collaboration, increase self-efficacy, and support decision-making. This study aimed to assess the association between patient-centered communication and patient awareness of the HPV vaccine. We also examined sociodemographic factors associated with HPV vaccine awareness.

Methods: The sample population included adults aged 18-45 (n=1384) from the 2022 Health Information National Trends Survey (Cycle 6). The outcome variable was HPV vaccine awareness (yes/no), assessed by whether the respondent has ever heard of the cervical cancer vaccine or HPV shot. The primary predictor variable was patient-centered communication, and this was operationalized using the 7-item Patient-Centered Communication scale (PCC scale). The items assessed respondents’ experiences during their healthcare visits, such as the chance to ask questions, attention to their feelings, involvement in decision-making, time availability, clarity of information presented, comprehension of information, and help with uncertainty. The scale response options ranged from 1=Always to 4=Never. The association between patient-centered communication and HPV vaccine awareness was examined using weighted multivariable logistic regression, while controlling for age, sex, race, education attainment, marital status, health insurance status, and number of healthcare visits in the past 12 months.

Results: The mean age of the sample population was 34.1 years (SD=7.2 years). Approximately 52.5% and 47.5% identified as women and men, respectively. Individuals identified as White non-Hispanic (56.2%), Black non-Hispanic (10.2%), Hispanic (19.6%), and Asian/Other non-Hispanic (14.0%). Approximately 40.4% of individuals had a college degree or higher, and 89.8% reported having health insurance coverage. Overall, 72.7% self-reported they had heard about the HPV vaccine. The PCC scale mean was 74.0 (range 0-100). Patient-centered communication was not statistically associated with HPV vaccine awareness. Compared to men, women had higher odds of HPV vaccine awareness (aOR=2.83; 95%CI=1.62-4.97). Individuals with some college (aOR=2.25; 95%CI=1.01-5.01) and college degree or higher (aOR=2.87; 95%CI=1.44-5.77) had higher odds of HPV vaccine awareness than those with less than a high school/12 years/high school diploma. Compared to individuals aged 18-26, individuals aged 27-45 had higher odds of HPV vaccine awareness (aOR=1.91; 95%CI=1.02-3.57). Black (aOR=0.24; 95%CI=0.12-0.49), Asian/Other (aOR=0.24; 95%CI=0.12-0.49), and Hispanic (aOR=0.36; 95%CI=0.21-0.59) individuals had lower odds of being aware of the HPV vaccine than whites.

Conclusions: The absence of statistically significant relationship between patient-centered communication and HPV vaccine awareness underscores the need to investigate other factors that influence patient knowledge and decision-making regarding the HPV vaccine. Provider recommendation is one of the known strategies to address misconceptions and increase uptake of the HPV vaccine, particularly among populations who are at increased risk for HPV. However, individuals with limited or no access to healthcare may seek health information from other readily available sources. Exploring racial/ethnic disparities in HPV vaccine awareness is imperative, including identifying effective, evidence-based dissemination strategies that meet the information needs of diverse populations.